Tropical Medicine & International Health最新文献

{"title":"Asymptomatic Tuberculosis in the Namibia National Tuberculosis Prevalence Survey: Occurrence Under Various Case Definitions.","authors":"Nunurai Ruswa, Gunar Gunther, Farai Mavhunga, Frank Cobelens, Mareli Claassens","doi":"10.1111/tmi.70206","DOIUrl":"https://doi.org/10.1111/tmi.70206","url":null,"abstract":"<p><strong>Background: </strong>Asymptomatic tuberculosis (TB) is emerging as a disease state warranting attention because it is presumed infectious, yet affected individuals lack symptoms. The World Health Organization recommends screening for cough, fever, weight loss and night sweats and recently defined asymptomatic TB. However, the place of these symptoms in the definition has not yet been standardised. We determined the proportion of patients with bacteriologically confirmed asymptomatic TB without four symptom definitions: persistent cough (> 2 weeks), cough of any duration, W4SS of any duration or W4SS for > 2 weeks.</p><p><strong>Methods: </strong>Secondary analysis of the Namibia TB prevalence survey data was performed; a representative sample had been interviewed for symptoms, underwent chest radiography and was offered bacteriological testing. The proportion of asymptomatic TB was computed for each definition. Logistic regression was used to determine factors associated with asymptomatic TB across four definitions.</p><p><strong>Results: </strong>Among 29,495 participants in the nationally representative sample (86.8% of the target sample size), 123 TB cases met the case definition. Mean age was 45 years, and 74 (60%) were male. Of TB cases, 60/123 (48.8%) reported a cough of any duration, 20/123 (16.3%) a fever of any duration, 25/123 (20.3%) weight loss and 26/123 (21.1%) night sweats. Asymptomatic TB ranged from 39.8% to 63.0% by definition, with screening based on prolonged cough missing 63.0% of bacteriologically confirmed TB patients, while screening based on W4SS any duration missed 39.8% of TB cases.</p><p><strong>Conclusion: </strong>Even when using an inclusive symptom screening system that includes any duration of the W4SS, asymptomatic TB occurred in 39.8%, highlighting a public health concern for asymptomatic TB. There is a need to standardise the symptoms being used when defining asymptomatic TB and we recommend the W4SS of any duration.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Behavioural Determinants of Cutaneous Leishmaniasis Through Community Dialogue in Kalu District, Ethiopia: A Mixed-Methods Study.","authors":"Takele Gezahegn Demie, Tara Mtuy, Jennifer Palmer, Eshetu Girma, Yohannes Hailemichael, Teklu Cherkose, Telahun Kasa Tefera, Mohammedjud Hassen Ahmed, Catherine Pitt, Michael Marks, Stephen L Walker, Endalamaw Gadisa, Mirgissa Kaba","doi":"10.1111/tmi.70194","DOIUrl":"https://doi.org/10.1111/tmi.70194","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous leishmaniasis (CL) is a major public health challenge in Ethiopia, with 20-30,000 new cases annually. Limited awareness and misconceptions contribute to delayed care seeking, stigma, prolonged healing, and reduced uptake of preventive measures in CL-endemic communities. To address these challenges, a participatory community dialogue (CD) intervention was implemented to evaluate a structured CD intervention in improving knowledge, attitudes, and preventive practices related to CL in Kalu District, Ethiopia.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods study was conducted in three CL-endemic clusters. Structured CD sessions were held between May and September 2024. Post-intervention qualitative data were collected through in-depth interviews with facilitators and mobilisers (n = 6) and 10 focus group discussions with participants (n = 81), analysed thematically. Quantitative data were obtained from questionnaires before (n = 128) and after the intervention (n = 109), compared using paired t-tests and odds ratios.</p><p><strong>Results: </strong>Participants in group discussions explained that CD sessions helped them to abandon misconceptions, such as beliefs that CL is transmitted through bat urine and that CL-affected people need to self-isolate during treatment to avoid contacts with those who had sexual intercourse and might cast a 'shadow' that could harm their healing. The intervention reframed contagion fears and encouraged biomedical explanations. Questionnaire data indicated attribution of CL to 'germs/parasites' increased from 21% (27/128) before the CD to 88% (96/109) after the CD and belief in self-isolation declined from 61% (78/128) to 8% (9/109). Perceptions of CL as preventable and treatable at health facilities increased, with modest improvements in preventive practices.</p><p><strong>Conclusions: </strong>The CD intervention addressed behavioural determinants of CL by improving knowledge, reducing misconceptions, and encouraging timely care seeking. It reduced shadow-related isolation beliefs and increased correct causal attribution, underscoring its potential to strengthen CL control in endemic settings. Integrating participatory approaches into public health strategies offers a pathway to sustain behavioural change.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Real Time Reverse Transcriptase Polymerase Chain Reaction for Chikungunya Virus Detection: A Systematic Review and Meta-Analysis.","authors":"Róger J Costa, Cleyde S C Marconi, Gleice K Jesus, Gabriel O Franco, Abevailton M Silva, Maria B Arriaga, Gúbio C Soares, Silvia I Sardi, Eduardo M Netto","doi":"10.1111/tmi.70203","DOIUrl":"https://doi.org/10.1111/tmi.70203","url":null,"abstract":"<p><strong>Background: </strong>Chikungunya virus (CHIKV) is an arbovirus that causes an acute febrile illness with intense muscle and joint pain, with the possibility of progressing to a chronic or neurological stage. We conducted a systematic review and meta-analysis with the aim of evaluating the accuracy of real-time reverse transcriptase polymerase chain reaction (RT-qPCR) protocols for detecting CHIKV during the acute phase of symptoms.</p><p><strong>Methods: </strong>We searched the literature until December 5, 2024, including English, Portuguese, and Spanish, with no time restriction in PubMed, LILACS, and Web of Science. Studies that evaluated RT-qPCR protocols compared to reference techniques such as viral isolation or validated RT-qPCRs were included in the study. We collected data on sensitivity, specificity, accuracy, study design and methodological characteristics of RT-qPCR. Quadas-2 tool was used to assess the risk of bias and applicability. Subsequently, a meta-analysis and meta-regression were performed.</p><p><strong>Results: </strong>Twenty-eight protocols were included in this systematic review, 28 index tests were extracted and 24 were included in quantitative analysis. According to meta-analysis, RT-qPCR for CHIKV detection had a combined accuracy of 96% (95% CI: 94 to 99%) and a summary sensitivity and specificity of 99.7% and 99.7%, respectively; however, the results need to be interpreted considering the high heterogeneity (78.1%) and publication bias (p = 0.002).</p><p><strong>Conclusion: </strong>RT-qPCR is a highly accurate technique for detecting the Chikungunya virus during the acute phase of symptoms. Despite the high heterogeneity observed, all subgroup analyses demonstrated high overall performance.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Molecular Characterisation and Zoonotic Potential of Blastocystis sp. in Humans and Domestic Animals: A Cross-Sectional Study From Northeastern Iran.","authors":"Fariba Berenji, Saeid Zoghdar-Moghadam, Ali Gholizadeh, Ghodratollah Salehi-Sangani, Mehdi Zarean, Lida Jarahi, Bibi-Razieh Hosseini-Farash, Seyed-Aliakbar Shamsian, Mohammad-Ali Mohaghegh","doi":"10.1111/tmi.70184","DOIUrl":"https://doi.org/10.1111/tmi.70184","url":null,"abstract":"<p><strong>Background: </strong>Blastocystis sp. is a common intestinal protist infecting humans and a wide range of animals worldwide. Despite its high prevalence, its genetic diversity and zoonotic transmission remain poorly understood, particularly in regions with close human-animal contact. This study aimed to determine the prevalence, subtype (ST) distribution and phylogenetic relationships of Blastocystis sp. in humans and domestic animals in northeastern Iran.</p><p><strong>Methods: </strong>In this cross-sectional study (2019-2021), 730 fresh faecal samples were collected from humans (n = 203) and domestic animals (n = 527). Samples were examined using direct smear microscopy and culture. DNA was extracted from culture-positive isolates and subjected to PCR targeting the SSU rRNA gene. PCR-positive amplicons were subsequently sequenced for ST identification, and phylogenetic analysis was performed using the Maximum Likelihood method.</p><p><strong>Results: </strong>Overall, 68 samples (9.3%) were positive for Blastocystis sp., with culture was significantly more sensitive than direct smear microscopy (p = 0.001). The prevalence among humans was 13.3%. Sequence analysis identified eight STs (ST1-ST3, ST5-ST7, ST14 and ST15). ST3 was the predominant ST in humans, while ST7 was mainly detected in poultry. Ruminant-associated ST14 and ST15 were exclusively found in sheep. Phylogenetic analysis revealed clear clustering according to STs and indicated greater intra-ST diversity within ST7.</p><p><strong>Conclusions: </strong>The findings demonstrate the circulation of genetically diverse Blastocystis sp. STs among humans and domestic animals in northeastern Iran. The presence of shared STs across hosts highlights the potential for zoonotic transmission and underscores the value of molecular approaches for epidemiological studies.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Altered Pharmacokinetics and Delayed Sputum Conversion in Tuberculosis Patients Co-Infected With HIV\".","authors":"Deepti M Sati, Vanashri Dhananjay Shinde, Chhaya Agarwal","doi":"10.1111/tmi.70204","DOIUrl":"https://doi.org/10.1111/tmi.70204","url":null,"abstract":"","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Occurrence of Two Arboviral Vectors, Aedes aegypti and Aedes vittatus (Diptera: Culicidae), and Their Associated Risk Factors From a Dengue Outbreak During 2024 in Ghana.","authors":"Godwin Deku, Dorothy Obuobi, Millicent Captain-Esoah, Stephen L Doggett, Rofela Combey, Isaac Kwame Badu, Emmanuel Younge, Godwin Kwame Amlalo, Ibrahim Kwaku Gyimah, Phyllis AKwaa-Sekyi","doi":"10.1111/tmi.70199","DOIUrl":"https://doi.org/10.1111/tmi.70199","url":null,"abstract":"<p><strong>Objective: </strong>The occurrence patterns of immature Aedes mosquitoes and associated risk factors were investigated during the 2024 dengue outbreak in Ghana.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in Accra, Ghana, to identify immature mosquito habitat sites coinciding with the country's first officially declared dengue outbreak. Potential developmental sites for immature mosquitoes were inspected, and collected immatures were identified. Field-collected pupae of Aedes species were used as indicators of species occurrence and to estimate habitat productivity.</p><p><strong>Results: </strong>A total of 49,931 immature mosquito stages were identified from 1085 habitat sites spanning 14 neighbourhoods in 4 districts of Accra. Aedes species comprised 18.5% (n = 9219) with Aedes aegypti (L.) and Aedes vittatus (Bigot), predominating and co-occurring sympatrically. The degree of infestation by both species across neighbourhood and habitat type was comparable and neither species was limited by habitat type. Discarded car tyres (n = 127/48.7%; pupal positivity = 75/127) and blocked drains (n = 76/29.1%; pupal positivity = 42/76) harboured most of the Aedes immatures (n = 7144/77.5%), and accounted for the highest Aedes pupal productivity (86.9%/650). The Relative Pupal Productivity (RPP) (%) between drain and car tyre across neighbourhood did not differ (p > 0.05) for neither Ae. aegypti nor Ae. vittatus though district/neighbourhood-level variation was noted. Furthermore, habitat type did not affect sex ratio.</p><p><strong>Conclusion: </strong>This study documents the significant presence of Ae. aegypti immatures in blocked drains and tyres in domestic environments in Accra during the 2024 dengue outbreak, and marks the first significant presence of Ae. vittatus, an experimentally proven transmitter of dengue viruses. The expansion of these vectors in urban habitats heightens Ghana's arboviral risk. This study was undertaken during the wet season, a peak period of dengue transmission; thus the findings offer valuable guidance for community-based preparedness, highlighting some key habitats for prioritization before and throughout the rainy seasons in Ghana.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water Pollution and Perinatal or Neonatal Outcomes: A Scoping Review.","authors":"Aditya Hemendra Bhatt, Shinjini Sahay, Somashekhar Marutirao Nimbalkar, Darshak Makadia, Shisher Agarwal, K Sameer","doi":"10.1111/tmi.70201","DOIUrl":"https://doi.org/10.1111/tmi.70201","url":null,"abstract":"<p><strong>Background: </strong>Water pollution is an increasingly important but underintegrated determinant of maternal and newborn health. Drinking-water contaminants such as heavy metals, nitrates, disinfection by-products, pesticides, per- and polyfluoroalkyl substances (PFAS), and industrial pollutants have been linked with adverse perinatal and neonatal outcomes, but the evidence is dispersed across pollutant classes, outcomes and regions. We aimed to map the scope and nature of the published evidence on water pollution and perinatal or neonatal outcomes.</p><p><strong>Methods: </strong>We conducted a scoping review using Joanna Briggs Institute methodology and reported the review in line with PRISMA-ScR guidance. PubMed, Embase and Scopus were searched through December 2024, with supplementary hand-searching of reference lists. Eligible studies evaluated exposure to water pollutants through drinking water or water supply systems and reported perinatal or neonatal outcomes. Two reviewers independently screened records and extracted data using a standardised form. Findings were synthesised descriptively.</p><p><strong>Results: </strong>Of 138 records identified, 95 remained after duplicate removal, 65 underwent full-text review and 42 studies were included. The evidence came from 26 countries across six continents. Prospective cohort, cross-sectional and case-control designs accounted for most studies. Heavy metals dominated the literature, especially arsenic and lead, while PFAS was the most prominent emerging contaminant group. Preterm birth, low birth weight and congenital anomalies were the most frequently examined outcomes. Across studies, higher exposure levels were repeatedly associated with adverse outcomes, with signals strongest for arsenic, lead, PFAS, cadmium, mercury, nitrates and mixed-pollutant exposure.</p><p><strong>Conclusions: </strong>The available evidence consistently suggests that water pollution is relevant to perinatal and neonatal risk. The literature is strongest for growth restriction, prematurity, birth defects and mortality-related outcomes, but important gaps remain in exposure standardisation, mixture analysis, neonatal phenotyping and intervention research. Water quality should be considered part of routine maternal-child health protection, especially in high-burden settings.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decline in Calmette-Guérin Bacillus Vaccination Coverage and Change in the Spatiotemporal Pattern of Extrapulmonary Tuberculosis in Children and Adolescents in Brazil: An Ecological Study, 2004-2023.","authors":"Alice Ramos-Silva, Luiza Silva Trigueiro de Oliveira, Marcos Daniel Souza da Costa, Matheus Daudt-Lemos, Luis Phillipe Nagem Lopes, Elisangela Costa Lima, Claudete Aparecida Araújo Cardoso, Clemax Couto Sant'Anna, Andrea Alice Silva, Fabiana Rabe Carvalho","doi":"10.1111/tmi.70198","DOIUrl":"https://doi.org/10.1111/tmi.70198","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between municipal BCG vaccination coverage and extrapulmonary tuberculosis (EPTB) notification rates among children and adolescents in Brazil and to describe their temporal, spatial, and spatiotemporal patterns from 2004 to 2023.</p><p><strong>Methods: </strong>We conducted an ecological study using national Brazilian administrative databases. Temporal trends in EPTB notification rates were assessed using Joinpoint regression and spatiotemporal clusters using retrospective space-time scan statistics. The association between municipal BCG coverage and EPTB notification rates was examined using municipality-year negative binomial models with an offset for the population aged 0-19 years. The main model adjusted for calendar year, primary health care team density, and municipal Human Development Index, with sensitivity analyses incorporating urbanicity, HIV case mix, and a CNES-based proxy of registered diagnostic infrastructure. Factors associated with extrapulmonary versus pulmonary presentation were evaluated using multivariable logistic regression.</p><p><strong>Results: </strong>EPTB notification rates declined overall but increased among children aged 0-4 years. Mortality showed a U-shaped temporal pattern, with a nadir around 2013. Local spatial autocorrelation identified high-high clusters concentrated mainly in the Southeast, Northeast, and North. Space-time scan analyses identified recurrent high-risk clusters, including a large early cluster in 2004-2007, a localized cluster in 2015-2016, and a recent cluster in 2019-2023. Higher municipal BCG coverage was associated with lower EPTB notification rates after adjustment (IRR per 10-percentage-point increase, 0.9755; 95% CI, 0.9646-0.9864). Urbanicity had minimal impact, whereas inclusion of registered diagnostic infrastructure shifted estimates toward the null. At the individual level, extrapulmonary presentation was associated with ages 5-9 and 10-14 years, male sex, and HIV positivity.</p><p><strong>Conclusions: </strong>Lower municipal BCG coverage was associated with higher EPTB notification rates among children and adolescents in Brazil. The association was modest and sensitive to contextual adjustment, particularly to indicators of diagnostic and service infrastructure.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virological Suppression Rate and Drug Resistance in Children and Adolescents Receiving Dolutegravir-Containing Antiretroviral Therapy in Ndop Health District, Cameroon.","authors":"Precious Nkam Ache, Herbert Afegenwi Mbunkah, Wijnand Mambi, Bella A Sama, Damian Nota Anong","doi":"10.1111/tmi.70196","DOIUrl":"https://doi.org/10.1111/tmi.70196","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed at evaluating the rate of virological suppression and profiles of HIV-1 drug resistance in HIV-positive children and adolescents taking Dolutegravir-based antiretroviral therapy in the Ndop health district of Cameroon.</p><p><strong>Methods: </strong>This hospital-based, cross-sectional study was carried out from February to May 2025. Children and adolescents (5-19 years) living with HIV-1, who had been taking Dolutegravir-based regimens for at least a year, were included in the study. Participants with virological failure (viral load > 1000 copies/mL) underwent HIV-1 genotypic resistance testing (RNA extraction, cDNA synthesis, nested PCRs and Sanger sequencing) targeting the reverse transcriptase and integrase regions of the pol gene. Mutations were interpreted using the Stanford HIV drug resistance database.</p><p><strong>Results: </strong>Out of 82 eligible participants receiving Tenofovir-Lamivudine-Dolutegravir (TLD) regimen, 75 (91.5%) achieved virological suppression (VL < 1000 copies/mL). Among 7 virally unsuppressed individuals, 5 (6.1%) were successfully genotyped. The major integrase resistance mutation G140GRS was detected in one participant (1/5; 20%). Univariate analysis to identify potential risk factors associated with drug resistance revealed no statistically significant associations. However, it was observed that major or accessory DRMs were more common in males, participants in secondary school and those taking antiretroviral drugs for a duration of 3-5 years.</p><p><strong>Conclusions: </strong>The TLD regimen remains highly effective in viral suppression, with very low resistance rates observed. Targeted adherence support for high-risk adolescents like those in secondary school is critical to preserve treatment efficacy.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resurgence of Typhoid Fever in Ghana: A Scoping Review of Epidemiology, Antimicrobial Resistance Patterns, Geographic Distribution, and Public Health Interventions.","authors":"Stephen Twumasi, Richard Owusu Ansah, Abdul Wasid Abubakari, Allwell Adofo Ayirebi, Bright Opoku Dankwah, Angela Opoku","doi":"10.1111/tmi.70202","DOIUrl":"https://doi.org/10.1111/tmi.70202","url":null,"abstract":"<p><strong>Background: </strong>Typhoid fever remains a major public health threat in Ghana, where the intensification of a long-standing endemic challenge is driving a re-emergence of the disease. This resurgence is fuelled by a complex interplay of escalating antimicrobial resistance (AMR), inadequate water and sanitation (WASH) infrastructure, and persistent diagnostic limitations. This scoping review provides a comprehensive synthesis of the current evidence on the epidemiology, AMR patterns, diagnosis, treatment and public health interventions for typhoid fever in Ghana.</p><p><strong>Methods: </strong>A systematic scoping review of peer-reviewed literature, national surveillance data and public health reports from January 2010 to August 2025 was conducted using databases including PubMed, Scopus and institutional repositories.</p><p><strong>Results: </strong>The incidence of typhoid fever remains high, with significant outbreaks in regions like Oti linked to environmental degradation from illegal mining. A critical shift in antimicrobial resistance is observed, with widespread resistance to first-line agents now compounded by emerging resistance to ciprofloxacin and decreased susceptibility to third-generation cephalosporins. Diagnostics remain a major challenge, with an over-reliance on the unreliable Widal test and underutilization of blood culture, which fuels a cycle of misdiagnosis and inappropriate antibiotic use. While public health interventions like WASH improvements and typhoid conjugate vaccine (TCV) rollouts are underway, they face significant logistical and financial hurdles to full implementation.</p><p><strong>Conclusion: </strong>The re-emergence of typhoid fever in Ghana is a complex public health crisis demanding an integrated response. Addressing this challenge requires strengthening diagnostic capacity, enforcing antimicrobial stewardship, accelerating TCV implementation, and making sustained investments in WASH infrastructure to break the cycle of transmission.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}